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720 Olive Drive, Suite D <br /> Davis, CA 95616 <br /> Lab:530.297.4800 <br /> ,�� <br /> ANALYTICAL cc c <br /> Fax:530.297.4803 Lab No. Page of <br /> Project Manager. Phone No.: <br /> Chain-of-Custody Record and Analysis Request <br /> Company/Address: FAX No.: For Lab <br /> CL Analysis Request Use Only <br /> P.O. No.: Project Name: co W.E.T.(X) <br /> Project Number: a E3' <br /> N N <br /> X TOTAL(X <br /> a ) <br /> Project Location: Sampler Signature;-? M co <br /> Lu <br /> 57D C K /a,- <br /> W 0W co <br /> Method <br /> Container 0 <br /> M CO W <br /> Sampling (Type/Arnount) Preserved Matrix = A A CM CM <br /> C) P e e <br /> km y In UJ <br /> C0 <br /> co 00 <br /> 0 C2 <br /> N 3: ca M M Qr a M C-4 <br /> co t- CL <br /> EL 0 r- r- r <br /> SampleQ g LLI 02 !z '0. (D a) <br /> X <br /> 0 z <br /> E z Lu W 0 6 0 <br /> 0 0 < n. a. 0 0 <br /> Designation Date Time Lo 0 z cc M F- Lo r- U-) r- Lu -J 0 <br /> ®r <br /> Relinquished Date Time Received by: Remarks: <br /> 13a . <br /> Relinquished by: Date Time Received ....... Email address: <br /> El.doc I-I.As. D.txt 11 other <br /> Relinquished by: Date Time Received by Laboratory: Bill to: <br /> it3b <br /> J <br /> Distribution: White-Lab, Yellow-File,Pink-Originator COC.fha(9/98) <br /> —---------------------------------------- ——--------------------------------- <br />